1. Grantmakers In Health - Webinar June 22, 2011 Presented By: Yvonne Cook Preventing Bullying: It’s Time to Make a Stand

2. About Highmark Foundation Founded in 2000 and solely funded by Highmark Inc. In 2005 & 2006 worked with Cone Inc., from Boston, MA to develop a platform 2006 launched Highmark Healthy High 5, a $100 million, five-year children’s health promotion initiative to support 5 critical areas: –Nutrition –Physical activity –Grieving –Self-Esteem –Bullying prevention Pursing the goals of: –Raising Awareness –Changing Behavior –Creating Healthy Environments 2

3. Why Bullying Prevention? Identified lack of programmatic activity with issues of bullying and self- esteem. Efforts were scattered and fragmented. Bullying is a factor in: Absenteeism Higher drop-out rates Lower academic achievement Diminished learning capacity Childhood depression Teen drug & alcohol use Teen suicide CDC made recommendations to prevent school violence which included “schools should implement a research-based bullying prevention program. 3

4. What do we know? Every day, 160,000 children miss school each day for fear of being bullied. Every seven minutes a child is bullied at school. If a student intervenes, the bullying will stop within 10 seconds. Bullies in middle school, without intervention, are three times as likely to have at least one criminal conviction by the age of 24. Without intervention, bullying behavior persists over time: a child who is a bully in kindergarten is often a bully in elementary, middle, high school and beyond. The impact of bullying stays with a person for a lifetime. 4

5. What do we know? Many children are involved in bullying situations, and most are quite concerned about it There are similarities and differences among boys and girls in their experiences of bullying Bullying is most common among elementary and middle school children than high school youth Children who bully are more likely to be engaged in other antisocial, violent, or troubling behavior Many children don’t report bullying experiences to adults Adults are not as responsive to bullying as they should be (and as children want them to be) 5

6. Health Consequences of Bullying Fekkes et al.(2003) Pediatrics, 144, 17-22 Bullied Not Bullied Headache16%6% Sleep problems42%23% Abdominal pain17%9% Feeling tense20%9% Anxiety28%10% Feeling unhappy23%5% Depression scale moderate indication49%16% strong indication16%2% 6

7. Bullying Prevention Objective Produce positive school climate change related to bullying behaviors. –Increase perceived teacher intervention –Increase perceived student intervention –Decrease perceived student fear of being bullied –Increase perceived student enjoyment of school 7

8. Defining Bullying A person is being repeatedly exposed to negative actions on the part of one or more persons and has difficulty defending him or herself. Bullying implies an imbalance in power or strength. Bullying can also be described as a “systematic abuse of power.” Myth: Bullying is the same thing as conflict. Reality is conflict involves antagonism among 2+ people. Any two people can have a conflict. Bullying only occurs where there is a power imbalance. 8

9. Our Plan Partner and collaborate with organizations in the field focused on bullying prevention Highmark Foundation embraced the Olweus Bullying Prevention Program, an evidence-based program known for decreasing bullying and is internationally recognized as the “blue-ribbon” bullying prevention program Identify gaps. Some pockets of success but scattered & fragmented Recognize bullying as a public health issue and executed on the model 9

10. Our Focus Coalition Building Bullying Prevention Institute (BPI) Continuing education Enhancements (e.g. quality assurance system) High School Cost-effectiveness analysis Publications and presentations Sustainability Plan –Implementation –BPI 10

11. “Misdirections” in Bullying Prevention & Intervention Zero tolerance Conflict resolution/peer mediation Group treatment for children who bully Simple, short term solutions 11

12. Best Practice – 10 Elements Change the school climate Leadership support & teacher involvement All staff Survey Evidence-based program Specific rules with + and – consequences Increase adult supervision Adults must intervene on the spot Coordinating groups & class time, videos, plays… No end date 12

13. Outcomes Positioned PA to be more proactive through a public health model rather then react to isolated incidents Most comprehensive effort to date in the U.S. to systematically and strategically address this important public health issue Reframe many of the OBPP components to make more manageable in the U.S. educational system 260,000 out of 1.8 million students (15%) in PA have been impacted and are from 446 school buildings in the Foundation’s 49 county service area More than 60,000 students are experiencing a safer, more productive school environment, because their peers are less likely to join in bullying Dramatic changes in student’s perceptions of their teacher’s ability to address bullying : –Teachers are more confident in their ability to intervene and intervene properly when they observe bullying –Teachers report bullying incidents more often; and engage in more appropriate discussions related to bullying 13

14. Outcomes Beginning with the population of students in public schools (with an average of 15 students per grade) in which the OBPP has been implemented, the rate of (1) bullying, (2) being bullied and (3) being a provocative bully as determined by the Olweus national bullying database was used to determine the number of students that would experience bullying (any of the three groups). Table 1 shows the students that experience bullying and the reduction with the OBPP implementation. Table 1. Population of students that experience bullying before OBPP implementation 14

15. OUTCOMES OBPP implementation results in reductions in students that experience bullying in all three groups. The percent reduction in the number of students that would experience bullying is based on the actual reductions seen with the PA implementation after Year 3. Table 2 shows the students that experience bullying following OBPP implementation. Table 2. Population of students that experience bullying after OBPP implementation 15

16. The Investment Since its inception, approx. $17 million has been spent on bullying prevention efforts in the Foundation’s 49-county service area in PA. –Build infrastructure –Build capacity –Develop resources –Increase knowledge –Monitor and evaluate –Purchase and development of support material for schools –Provide education for schools, trainers, parents, administrators –Parent and student crisis support –Education and awareness efforts Developed a coalition of administrative, educational, public health and programmatic experts 16

17. Cost/Benefits of Bullying First ever cost effectiveness analysis of bullying prevention in the U.S. Cost benefit analysis model is based on the premise that with reductions in bullying there will be a reduction in utilization for these health problems Thus, costs savings to the insurer are based upon decreased utilization from reductions in bullying Working with an economists to develop an analysis that will reflect the effectiveness of investment in three areas: –Health –School –Criminal Justice (Society) 17

18. Cost Benefit Analysis Results: –Cost for implementation: $20.16/student for 3 years ($6.72/year ave.) –Cost savings over 3 years: $21.00/student which completely covers implementation actual costs over 3 years. –Cost Savings @ $20.16/student X 210,000 students = $4,233,600 over three years of implementation –Cost Benefit @ $0.84/student above and beyond implementation costs = $176,400 18

19. Contact Information Highmark Foundation, Highmark Healthy High 5 – Janice Seigle - (412) 544-4147 j.seigle@highmark.com j.seigle@highmark.com http://www.highmarkhealthyhigh5.org/bullying/index.shtml Center for Safe Schools - Lynn Cromley - (717) 975-7841 http://www.safeschools.info/bullying-prevention http://www.safeschools.info/bullying-prevention Windber Research Institute, Center for Health Promotion and Disease Prevention - Matthew Masiello, MD, MPH - (814) 619-6168 m.masiello@wriwindber.org & Diana Schroeder - (814) 361-6961 d.schroeder@wriwindber.org http://www.wriwindber.org/wriwindber/CenterforHealthPromotion.aspxm.masiello@wriwindber.orgd.schroeder@wriwindber.org http://www.wriwindber.org/wriwindber/CenterforHealthPromotion.aspx Clemson University, Olweus Bullying Prevention Program – Susan Limber, Ph.D. - (864) 656-6320 http://www.clemson.edu/olweus/ Dan Olweus, Ph.D., Research Center for Health Promotion, Norway - olweus@online.no olweus@online.no 19

20. Contact Me Yvonne Cook President Highmark Foundation Pittsburgh, PA 15222 (e) yvonne.cook@highmark.comyvonne.cook@highmark.com (p) (412) 544-6610 20